Closer is not better. Distance and proximity in the use of health care by women living with HIV and AIDS in Ouagadougou (Burkina Faso)

The particular concern of HIV health care policies is with the transmission of the virus from mother to infant, from delivery until cessation of breastfeeding. PMTCT care seeks to help women reduce the risk by providing suitable services. In Burkina Faso, the authorities have chosen to bring health care facilities physically closer to HIV-positive women by increasing provision and thereby reducing the distance of access to them. Our purpose is to define the area in which these health care practices take place and the factors that determine them. 30 women were monitored for this study, from pregnancy until the infant reached six months of age, in Ouagadougou, the capital of Burkina Faso. The results show the women's active involvement in attending PMTCT services. They travel long distances in a difficult physical environment, often using precarious means of transport. But the relationship between the distances from place of residence and health care is unexpected. The observations are at variance with research studies which show that the distance from health care facilities is not a criterion of attendance. While urban studies present distance as a neutral factor in the context of the use of care health services, our research shows distance as a criterion for attendance. Regardless the means of transport used, women travel long distances for PMTCT follow-up, as opposed to usual care.